Alternative physical therapy protocol using a cycle ergometer during hospital rehabilitation of coronary artery bypass grafting: a clinical trial

Abstract

OBJECTIVETo compare the efficacy of a cycle ergometer-based exercise program to a standard protocol on the increment of the maximum distance walked during the six-minute walk test in the postoperative rehabilitation of patients submitted to coronary artery bypass grafting.METHODSA controlled clinical trial pilot, blinded to the outcome, enrolled subjects who underwent coronary artery bypass grafting in a hospital from Southern Brazil. Subjects were designated for the standard physical rehabilitation protocol or to an alternative cycle ergometer-based protocol through simple random sampling. The primary outcome was the difference in the maximum distance walked in the six-minute walk test before and after the allocated intervention.RESULTSTwenty-four patients were included in the analysis, 10 in the standard protocol and 14 in the alternative protocol group. There was an increment in the maximum distance walked in both groups, and borderline superiority in the intervention group comparing to the control group (312.2 vs. 249.7; P=0.06).CONCLUSIONThere was an increase in the maximum distance walked in the alternative protocol compared to the standard protocol. Thus, it is postulated that the use of a cycle ergometer can be included in physical rehabilitation in the hospital phase of postoperative coronary artery bypass grafting. However, randomized studies with larger sample size should be conducted to assess the significance of these findings.

Physical Exercise Combined With CPAP in Subjects Who Underwent Surgical Myocardial Revascularization: A Randomized Clinical Trial

“…However, studies that examine the comparative effects between isolated physical training on a cycle ergometer and this training associated with CPAP are still needed. Other studies 11,23 did not show additional effects of isolated physical training using a stationary bicycle when compared to ambulation. In our study, functional capacity was recovered in subjects who performed the physical exercise combined with CPAP, demonstrating a benefit when compared with the step group.…”

“…Based on the results of a previous study 11 and assuming that subjects following the step program had a stable 6-min walk test (6MWT), we estimated a sample size of 15 subjects per group to achieve a statistical power of 80% to detect a 10% difference in the distance walked. Subjects were randomly assigned by simple randomization (ie, random assignments by raffle with sealed envelopes) in a ratio of 1:1 to receive treatment in the step group or the intervention group.…”

“…Previous studies have shown that surgical intervention decreases the distance walked on the 6MWT 11,23 as well as the respiratory muscle strength 24,20 when comparing the preoperative period with the postoperative period (evaluated before hospital discharge). In this context, the hospital physiotherapeutic intervention seeks to diminish this reduction, allowing the patient to obtain better physical and functional conditions at hospital discharge, as well as reducing the ICU length of stay and the overall hospital length of stay.…”

“…8,9 The use of physical exercise in the postoperative period of cardiac surgery has demonstrated recovery and maintenance of functional capacity in patients who performed exercises on a cycle ergometer during their hospital stay. 10,11 In addition to the already widely recognized benefits of postoperative CPAP (eg, improvement of oxygenation, decreased need for endotracheal intubation, and reduction of pulmonary complications 12 ). However, to our knowledge, cycle ergometer exercise combined with CPAP in the postoperative period of cardiac surgery has not yet been studied.…”

Effects of cycle ergometer use in early mobilization following cardiac surgery: a randomized controlled trial

“…This simple to use stationary equipment allows upper and lower limb exercise training during voluntary active cycling or passively induced cycling with or without resistance. 5 Because it is a feasible, practical and safe device 6 for improving functional capacity, 7 inspiratory 8 and peripheral muscle strength, 9 the cycle ergometer has been used in intensive care units (ICUs).…”